Antinociceptive synergism in preclinical studies: A review

Hugo F Miranda 1, *, Viviana Noriega 2, 3, Fernando Sierralta 4, Ramón Sotomayor-Zárate 5 and Juan Carlos Prieto 1

1 Department of Faculty of Medicine, Universidad de Chile, Santiago, Chile.
2 Faculty of Medicine, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
3 Department of Clinical Hospital, Universidad de Chile, Santiago, Chile.
4 Pharmacology Program, ICBM, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
5 Center for Integrative Neurobiology and Physiopathology (CENFI), Institute of Physiology, Faculty of Sciences, University of Valparaíso, Chile.
 
Review
International Journal of Science and Technology Research Archive, 2022, 03(01), 031–040.
Article DOI: 10.53771/ijstra.2022.3.1.0055
Publication history: 
Received on 24 May 2022; revised on 29 June 2022; accepted on 01 Jully 2022
 
Abstract: 
In the treatment of acute and chronic pain the most frequently used drugs are nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., paracetamol; opioids, e.g., tramadol, and a group of drugs called coanalgesics or adjuvants (e.g., antidepressants, anticonvulsants). When the administration of an isolated drug produces a minimal analgesic effect, multimodal analgesia is usually used, which consists of the co-administration of two drugs, which can produce an increase in the sum of the effects of each component, generating a synergistic effect or supradditivity or superadditivity. Synergism has been the objective of pharmacology, due to its biomedical orientation, due to its outstanding effect in the therapeutics of pain and mainly cancer. Among the advantages of synergism is that (i) reduction of drug doses and increase in therapeutic effect, (ii) reduction of side effects of each component, (iii) possibility of an increase in the speed of appearance of the effect and prolongation of its action. The exact mechanism of the synergistic interaction has not been exhaustively described, there are only theories of events that can occur at the pharmacokinetic level, due to changes in the concentration of the agents in the site of action or at the pharmacodynamic level, due to changes in the mechanism of action of drugs. This work, was reviewed reports of the preclinical analgesic synergism of NSAIDs with opioids and the mechanisms of action involved in the therapy of these useful analgesic drugs, which may be relevant for pain relief.
 
Keywords: 
Opioids; NSAIDs; Pain; Analgesia; Synergism
 
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